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General NPI Number Information
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NPI Number | 1720551674
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Entity Type | Individual
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Provider Name | MEAGAN MAHTUSHQUAH APRN
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Gender | Female
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Dates
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Enumeration Date | 01/03/2019
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Last Update Date | 02/07/2025
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Provider Practice Location Address
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Address Line | 3916 S SUNNYLANE RD
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City | OKLAHOMA CITY
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State | OK
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Zip | 73115-3656
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Country | US
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Telephone | 405-812-2515
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Fax |
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Provider Business Mailing Address
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Address Line | 1919 WILMINGTON CT
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City | NORMAN
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State | OK
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Zip | 73071-2232
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Country | US
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Telephone | 405-948-4900
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 117483
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 220103
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License Number State | OK
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